Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2012 -00192
T I G A O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/18/2012
Parcel: 2S 101 DA00102
Jurisdiction:
Site address: 13221 SW 68th PKWY 450
Project: Spec Space Subdivision: VARNS ACRES Lot: 9
Project Description: HVAC modifiactions: remove (3) supply ducts & diffusers, relocate (5) supply diffusers, relocate (4) return grills &
add (1) new supply duct and diffuser.
Contractor: AMERICAN HEATING INC Owner: GK TRIANGLE CORPORATE PARK III
1339 SE GIDEON ST P.O. BOX 130174
PORTLAND, OR 97202 CARLSBAD, CA 92013
PHONE: 503 - 239 -4600 PHONE: 503 - 221 -1900
FAX: 503 - 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/18/2012 $246.55
Class of Work: ALT Type of Const: Plan Review 04 /18/2012 $61.64
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 04 /18/2012 $29.59
Stories:
Project Valuation: $6,324.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
•
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $337.78
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct question UNC by c ing 503.232.1987 or 1.800.332.2344. _
Issued By: Permittee Signature: k Brov I M€iic X-es-/ey
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application roR OFFICE USE ONLY
R eceived
Date /By: ��
City of Ti and / i Permit No.: M Pd l7
IY GO
�J g , c
;� q 13125 SW Hall Blvd., Tigard, : 3� n\
Phone: 503.718.2439 Fax: 8t 96Q 1 'i '' i Date/By: Other Permit: • Inspection Line: 503.639.417 L -11 v I ii -, �� �,����
T I G A R D Date Ready /By: Luria: ® See Page 2 for •
Internet: www.tigard - or.gov APR 18 2012 Notified/Method: Supplemental Information
TYPE 611 RK' br AF .,:n COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
-W �°
� nr • Nit permit fees* are based on the value of the work
1:1 New construction ® Addif //I NiTh 7;ic=+y Nit performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ 6,324
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 13221 Sw 68 Parkway (requires site plan showing placement) 46.75
City/ State/ZIP: Tigard OR 97223 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 450 Project name: TCP III 903312 .SPfe. a,Oqe l_ Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
remove 3 existing 3 supply ducts and diffusers Gas fireplace/ water 33.39
Flue vent foor r w ater heater or gas
relocate 5 existing supply diffusers fireplace 23.32
Log lighter (gas) 23.32
relocate 4 existing return grilles Wood/pellet stove 33.39
add one new supply duct and diffusers Wood fireplace/insert 23.32
❑ PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
F ax: Single -duct exhaust (bathrooms,
Phone:
( ) ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: American Heating
Other: 23.32
Fuel piping:
Contact name: Brad Manchester $14.15 for first four; $4.03 for each additional
Address: 1339 SE Gideon St Furnace, etc.
Gas heat pump
City/ State/ZIP: Portland OR 97202 Wall/suspended/unit heater
Phone: (503) 239 - 4600 Fax: : (503) 239 -7038 Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: American Heating Clothes dryer (gas)
Other:
Address: 1339 SE Gideon Street MECHANICAL PERMIT FEES*
City/State/ZIP: Portland OR 97202 Subtotal At/( ,55
Phone: (503) 239 -4600 Fax: (503) 239 -7038 Minimum permit fee ($90.00) �—
Plan review (25% of permit fee) j,/ .&3tt
CCB lic.: 33135 - State surcharge (12% of permit fee) A9, pi
TOTAL PERMIT FEE g 3 2 7g
Authorized signature: / / / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Brad Manchester I Date: 4/18/2012 • Fee methodology set by Tri-County Building Industry Service Board
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